I have remained uninvolved in the work of seeking change in the form of Assisted Suicide/Death With Dignity/Voluntary Euthanasia. Though I do absolutely support another means of providing choice to those at the end of their lives, this option would be of little help to those whose situations I speak about here. As it stands now, in order to take advantage of the new legislation (assuming that it is passed) it would be necessary to find two doctors who would agree that a person has six months or less to live. This is the same amount of time that is required in order for a physician to endorse a hospice level of care. And I already know that many doctors are reluctant to even do that.
Guidelines exist to assist physicians in this endeavor by outlining conditions that must be present to be eligible for the Medicare Hospice benefit. These are not inclusive of the cancer diagnoses which trigger an easier identification with impending death thus making it easier to earn a hospice referral. For some of my elderly acquaintances who strongly oppose the possibility that they will be hospitalized, fear sets in when memory begins to fail. This is a signal that mental clarity will be questioned and inconsistent responses will be construed as “lacking the capacity to make important decisions”. For those with dementia this is the danger zone when control of one’s own life is very much at risk. For those whose family members are reluctant to discuss or to take seriously or to agree with a loved ones plan…this truly is the end of life as they have known it.
It is a sad commentary on our medical model of care that an elder who wishes to avoid the prolonged death that institutions have to offer is forced to stop eating and drinking. I have known persons who have made this choice and then struggle to know when they should undertake this tremendous effort …before they forget their resolve. This seems wrong to me. I have just begun to read a book by an Australian author, Rodney Syme, entitled A Good Death. The foreword of this book is written by Pamela Bone who states that there is “a sense of the inevitability of change: that those individuals who would impose on others – even those who do not share their religious convictions – the unwanted prolongation of life in futile and undignified circumstances will increasing be seen to be acting invalidly.” Here Here.